昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
36 巻, 1 号
選択された号の論文の7件中1~7を表示しています
  • (血清酵素及び血液ガスの変動を中心として)
    中島 正和
    1976 年 36 巻 1 号 p. 1-15
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    In order to investigate the degree and development about the interruption of the blood flow in the lowerextremities, the lower abdominal aorta of the dog was occluded as the experimental model.
    To makc the acute cases, abdominal aorta was ligated, and gradual constrictor was used to make subacute and chronic cases.
    The results obtained were as follows:
    1) In acute cases, the serum CPK level increased gradually and showed a high level for 120 minutes clearly. Comparison of the venous serum CPK level in the upper extremity, and the lower extremity, the later was higher and the difference was clear with the prolongation of occlusive period. Concerning the venous blood gas exchange in the lower extremity, an increase in PVCO2, a decrease in PVO2, and a reduction of PH were recognized. It seemed That a metabolic change had occured.
    2) In all cases, there were no significant changes in S-GOT, S-GPT, S-LDH and serum CPK levels.
    3) In chronic cases, there were some cases of increase of the serum CPK level in the 2 weeks group, after 3 weeks, however, it returned to normal level.
    4) Angiographic observation of collateral circulation showed that the higher of occlusive changes were, the more development of bypass was found.
    5) Histologically, fibrous hypertrophy in the intima, inflammatory changes in the ads ventitia around the constricted region, and no change in the media were observed.
    6) As a result, by measuring the serum CPK leve and PVO2 in the circulatory obstructive extremity, it seemed to be able to estimate the begining of an acute circulatory deterioration even in a chronic case.
  • ―主として微小循環面からの考察―
    中山 寿朗
    1976 年 36 巻 1 号 p. 17-27
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    The author observed the micro-circulatory behavior in stomach, intestines and abdominal walls during experimental dumping for the purpose of elucidating its mechanism of onset. The method consisted in examining micro-circulatory changes in these organs of mouse or adult rat weighting about 100 grams, under the influence of dumping induced by injection of 2 ml of 50% glucose solution into upper jejunum.
    As a result, the blood flow became slow in a few minutes after the injection, accompanying stasis, sluding of blood cells, regurgitation, etc., and such changes reached to the maximum in 10 to 15 minutes, returned to normal in about 50 minutes. And contraction of intestinal villi and stasis of villous blood flow were also observed immediatery after dropping of 50% glucose solution directly on jejunal mucosa, and blood flow began to recover gradulally in a few minutes, returned completely to normal in about 50 minutes.
    Based on the idea that such changes may be due to a vasoactive substance, the author intended to examin micro-circulatory changes by dropping solutions of serotonin, his-tamin, epinephrin and bradykinin, while observing the capillary circulation in serous surface of intestinal wall of rat. The result is that serotonin showed similar changes to the micro-circulatory changes which was observed in case of the experimental dumping, accompaying the sludge phenomenon.
    On the presumption that serotonin have an effect upon such micro-circulatory changes, it was examined, eventual liberation of sorotonin was studied by a fluoro-histochemical method on serotonin-containing cells within jejunal wall. The result was that in jejunal mucosa, 15 minutes after injection of 50% glucose, there was a remarkable reduction in serotonin-fluorescence, which was obsered in abundance before, and that even 15 minutes after, there was no such reduction in those mucosa which had not come in contact with the glucose solution injected.
    From the experiments, the author conclude that early dumping syndrome might be caused by a general disturbance of the capillary circulation, associated with local insufficiency due to the osmotic pressure and subsequent liberation of serotonin, after the intake of high osmotic meal into upper jejunum.
  • 松崎 史朗
    1976 年 36 巻 1 号 p. 29-37
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    By promtly giving an intravenous injection of 10 ml/kg of H.E.S. to a dog of normovolemia, the auther cross-examined change of blood gas, acid-base balance and circulatory movement. The effect obtained were as follows:
    1. The rise of Po2 after the H.E.S. injection was so little, as compared with that in clinical examples, that it was not considered to be satistically much significant.
    2. Notwithstanding the insignificant change of Paco2, after the H.E.S. injection, PHa went down significantly, base dificit increased, and metabolic acidosis was found generated.
    3. From the viewpoint of falling down of hemoglobin concentration, it seemed that the effect of plasma expander would be preserved at least for 60 minites.
    4. After the H.E.S. injection, it was recognized that cardiac output considerably increased, arterio-venous oxygen content conspicously decreased, and accordingly, oxygen consumption diminished remarkably, suggesting some trouble on oxygen utilization in tissues.
    It was supposed that this, together with the diluted acidosis, would be one of the reasons of the abovestated metabolic acidosis.
    5. With the H.E.S. injection, blood was diluted, hemoglobin concentration was weakened, and hence arterio-venous oxygen content was decreased, but according to the exceeding increase of cardiac output, oxygen availabilty was rather increased.
    6. After the H.E.S. injection, physiologycal shunt was increased, but it was not much increase as compared with that of cardiac output.
    7. After the H.E.S. injection, a tendency of A-aDo2 decrease was shown, but the change was not much significant.
    8. With the H.E.S. injection, mean arterial blood pressure was not changed, but cardiac output was increased and peripheral resistance was decreased.
  • 中島 宏
    1976 年 36 巻 1 号 p. 39-48
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Pharmacological effects of thiamine and its derivatives on the central nervous system, particularly on its part regulating the blood pressure were studied and the following results were obtained:
    1) The blood pressure rose on an average to 48 and 30 mmHg at a dosis of 20 and 10 mg thiamine hydrochloride, respectively, whereas the mean pressure rise with an admini-stration of 10 mg thiamine diphosphate was 41 mmHg.
    2) When combined with antihistaminics, neither the administration of thiamine hydro-chloride nor that of thiamine diphosphate raised the blood pressure.
    3) For the effect of thiamine to raise the blood pressure, tachyphylaxis was recognized.
    4) Histamine was estimated quantitatively using a piece of small intestine from guinea pig. Administration of 20 and 10 mg of thiamine hydrochloride gave 10-8 and 10-8 to 10-10 g/ml histamine, respectively, whereas 10 mg thiamine diphosphate resulted in 10-9 to 10-10 g/ml.
    5) The effluence of cereblospinal fluid was subjected to fluorescence monochromator after it was treated by the Shore's method. Activation with 320mμ gave a peak fluorescence of 420 mμ, identifying histamine.
    6) It seems very likely that the rise of the blood pressure associated with the administration of thiamine in the lateral ventricle was caused by histamine that was released by mast cells of hypophysial stalk and posthypophysis so that the compound reacted with intraventricular chemoreceptors.
  • 岩本 壮太郎
    1976 年 36 巻 1 号 p. 49-62
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    The extensibility of 19 arteries in 60 adults (30 males, 30 females) from 20 to 80 years old were measured and examined. The extensibility was higher for arteries at bending positions such as A. poplitea, A. femoralis, A. carotis comm. and A. axillaris, and at unfixed positions such as A. mesenterica sup. et inf, and A. ovarica ; it was lower for arteries which accompanied bone such as A. subclavia, A. tibialis ant. et post., A. ulnaris and A. radialis. Generally, the elongation, as a function of increased load, showed the S-shaped curve described by Roy et al., but the relationship was linear for some arteries such as A. iliaca comm. et ext., Truncus brachio-cephalicus, A. axillaris, A. carotis int. et ext. (female) . Extensibility was the greatest at ages in the twenties, decreased with age, and was smallest at ages in the seventies. These characteristics were exhibited by the arteries having high extensibility and at high load, but, as exceptions, a tendency to decrease began to appear in the sixties for A. renalis and A. ovarica. The median values of extensibility decrease occurred at the lower ages for A. carotis comm. (female) and A. mesenterica sup. et inf. (male), and at the higher ages for Tr. brachio-cephalicus, A. subclavia, A. radialis, A. tibialis ant. et post., A. testicularis A. poplitea (female), A. axillaris (female) and A. ulnaris (female) . The median values generally occurred at a later age in females than in males.
  • 佐野 新, 石橋 守正, 野津 立秋, 大栗 茂芳, 太田 秀一, 坂本 言方, 高野 憲一郎, 鶴岡 延熹, 諸星 利男
    1976 年 36 巻 1 号 p. 63-70
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    The 61 year old woman suffered from chronic myeloid leukemia was treated with busulf an and splenic irradiation since April 1970.
    Almost 3 years later, tender tumor of thumb-tip size appeared in her right temporal area.
    Although she had no evidence for blastic transformation in hematological examination, combined therapy with 6-mercaptopurine, busulf an and prednisolone were performed.
    However, the enlargement of the tumor was developed and she died of apoplectic attack on February 1973.
    At postmortem examination, the tumor was myeloblastoma 5×5 cm in size which de-stroyed the temporal bone and compressed the temporal lobule with infiltration of tumor cells.
    A review of the previously reported cases in literature was made.
  • 高場 利博, 善山 金彦, 高尾 資朗, 荒井 潔, 帆刈 睦男
    1976 年 36 巻 1 号 p. 71-74
    発行日: 1976/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Predialysis studies were performed about the 12 chronic dialysis patients and the results demonstrated the slightly bellow normal range in the mean circulating blood volume, but in the patients with circulatory congestion it was higher than that of no circulatory congestion group, and the clinical symptom in the both group was different significantly.
    The mean circulatory blood volume was decreased in postdialysis examination, but in three cases with blood transfusion it was increased.
    These findings suggest that it is important to control the uremic patients under the low circulating volume stage to prevent the incidence of circulatory congestion.
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